Conhecimento da doença e nível de ativação do paciente ambulatorial com insuficiência cardíaca crônica: um estudo tranversal
Conhecimento da doença e nível de ativação do paciente ambulatorial com insuficiência cardíaca crônica: um estudo tranversal
Data
2023
Autores
Carvalho, Gabrielle Manso de
Journal Title
Journal ISSN
Volume Title
Publisher
Instituto Nacional de Cardiologia
Resumo
Introdução: A Insuficiência Cardíaca (IC) é uma síndrome na qual o coração é
incapazde bombear sangue corretamente comprometendo as demandas metabólicas
tissularespor redução do débito cardíaco causando aos pacientes diversas limitações.
A capacidade de autogerenciamento em saúde é mensurada através da medida de
ativação do paciente, se o mesmo está equilibrado emocionalmente,
consistentemente positivo para enfrentar novos desafios, resiliente e capaz de mudar
suas rotinas atravésde metas traçadas. Metas desafiadoras podem mantê-lo com alto
grau de motivação e foco em sua saúde. O paciente precisa estar ativado, ter
conhecimento,habilidade ou confiança para se engajar no gerenciamento da própria
saúde. Isto impacta favoravelmente no comportamento do paciente e nos resultados.
Estes devem estar aptos a gerenciar hábitos saudáveis de vida, identificar medicações
prescritas, períodosde descompensação, comportamentos saudáveis e adesão às
orientações da equipe. Deste modo, quanto maior for a capacidade do indivíduo em
atuar nestes aspectos melhor serão os desfechos para sua saúde. Objetivos:
Verificar a relação entre conhecimento sobre a doença e o nível de ativação do
paciente com Insuficiência Cardíaca atendidos ambulatorialmente. Os objetivos
específicos foram apresentar o perfil sociodemográfico e clínico dos pacientes com
Insuficiência Cardíaca atendidos ambulatorialmente, descrever o nível de
conhecimento sobre a doença dos pacientes com Insuficiência Cardíaca atendidos no
Ambulatório e descrever o nível de ativação dos pacientes com Insuficiência Cardíaca
atendidos no Ambulatório de um hospital especializado. Metodologia: Tratou-se de
um estudo transversal, de natureza quantitativa. Aplicou-se formulários de
conhecimento de Bonin e de nível de ativação dopaciente (PAM 13). Realizado análise
estatística simples e para avaliar a correlação entre as variáveis usou-se o teste de
correlação de Spearman. Resultados: Amostra de100 pacientes, majoritariamente
masculina (54%) de faixa etária entre 51 a 65 anos (38%), de cor branca (37%).
Prevaleceu indivíduos com nível médio de ensino (47%), renda familiar até 2 salários
mínimos (67%), classe funcional II (43,6%),hipertensos (55%), não diabéticos (72%),
não dislipidêmicos (58%) e sem doença coronariana prévia(78%). A maioria relatou
não ter sofrido IAM (64%), não ter realizado qualquer cirurgia cardíaca (74%)nem ter
diagnóstico de Arritmias cardíacas (63%). O escore de Bonin avaliou o nível de
conhecimento do paciente sobre a doença como aceitável com 38% e o nível de
ativação apresentado pelos pacientes, foi o nível 4 com 35% da amostra. Aanálise
dos dados permitiu concluir que existe uma correlação positiva fraca entre os
formulários analisados. Conclusão: Este estudo permitiu conhecer os níveis de
ativaçãoe de conhecimento dos pacientes atendidos na instituição, possibilitando um
planejamento direcionado e medidas educativas focadas na ampliação do
conhecimento e no engajamento em saúde dos mesmos. Ademais, a pesquisa
evidencia a importânciada autogestão dos pacientes para melhores resultados em
saúde motivados por suas autonomias no processo de cuidado.
Palavras-chave: Assistência Centrada no Paciente; Autogestão; Autocuidado;
Insuficiência Cardíaca; Troca de Informação em Saúde.
Introduction: Heart Failure is a syndrome in which the heart is unable to pump blood properly, compromising tissue metabolic demands by reduced cardiac output, causing patients several limitations. Self-management in health is measured by patient's activation, whether he/she is emotionally balanced, consistently positive to face new challenges, resilient and able to change his/her routines towards established goals. Challenging goals can keep patients highly motivated and focusedon their own health care. Patients need to be activated and to have the knowledge, skill or confidence to be engaged in the management of their own care. This favorablyimpacts patient’s behavior and outcomes. Patients must be able to manage healthy life habits, to identify prescribed medications and periods of clinical decompensation, to adopt healthy behaviors and to adhere to the team's guidelines. Thus, the greaterthe individual's ability to act in these aspects, the better the outcomes for their health.Objectives: to verify the relationship between knowledge about the disease and thelevel of activation of patients with heart failure treated at an outpatient specialized clinic. The specific objectives were to present the sociodemographic and clinical profile of patients with Heart Failure treated at an outpatient clinic, to describe their level of knowledge about the disease and their level of activation. Methodology: Thiswas a cross-sectional, quantitative study. Bonin's knowledge forms and the patient's level of activation questionnaire (PAM 13) were applied. Simple statistical analysis was performed to evaluate the correlation between the variables using the Spearman correlation. Results: A sample of 100 patients (37% white), mostly male (54%), agedbetween 51 and 65 years-old (38%) was selected for analysis. Prevailed individuals with high school education (47%), family income up to 2 minimum wages (67%), functional class NYHA II (43.6%), systemic hypertension (55%), non-diabetic (72%),with no previous history of dyslipidemia (58 %) and without previous coronary disease (78%). Most patients reported not having suffered acute myocardial infarction (64%), not having undergone any heart surgery (74%) or having a diagnosis of cardiac arrhythmias (63%). The Bonin score evaluated the patient's level of knowledge aboutthe disease as acceptable within 38% of the studied population and the level of activation was level 4 within 35% of the sample. There was a weak positive correlationbetween the analyzed forms. Conclusion: This study showed a low level of activationand knowledge of the disease for the patients treated at a specialized heart failure clinic. There is a positive correlation between patient activation and knowledge of thedisease. This may enable targeted planning and educational measures focused on expanding their knowledge and engagement in their health care. Keywords: Patient-Centered Care; Self-management; Self-care; Heart Failure; Health Information Exchange.
Introduction: Heart Failure is a syndrome in which the heart is unable to pump blood properly, compromising tissue metabolic demands by reduced cardiac output, causing patients several limitations. Self-management in health is measured by patient's activation, whether he/she is emotionally balanced, consistently positive to face new challenges, resilient and able to change his/her routines towards established goals. Challenging goals can keep patients highly motivated and focusedon their own health care. Patients need to be activated and to have the knowledge, skill or confidence to be engaged in the management of their own care. This favorablyimpacts patient’s behavior and outcomes. Patients must be able to manage healthy life habits, to identify prescribed medications and periods of clinical decompensation, to adopt healthy behaviors and to adhere to the team's guidelines. Thus, the greaterthe individual's ability to act in these aspects, the better the outcomes for their health.Objectives: to verify the relationship between knowledge about the disease and thelevel of activation of patients with heart failure treated at an outpatient specialized clinic. The specific objectives were to present the sociodemographic and clinical profile of patients with Heart Failure treated at an outpatient clinic, to describe their level of knowledge about the disease and their level of activation. Methodology: Thiswas a cross-sectional, quantitative study. Bonin's knowledge forms and the patient's level of activation questionnaire (PAM 13) were applied. Simple statistical analysis was performed to evaluate the correlation between the variables using the Spearman correlation. Results: A sample of 100 patients (37% white), mostly male (54%), agedbetween 51 and 65 years-old (38%) was selected for analysis. Prevailed individuals with high school education (47%), family income up to 2 minimum wages (67%), functional class NYHA II (43.6%), systemic hypertension (55%), non-diabetic (72%),with no previous history of dyslipidemia (58 %) and without previous coronary disease (78%). Most patients reported not having suffered acute myocardial infarction (64%), not having undergone any heart surgery (74%) or having a diagnosis of cardiac arrhythmias (63%). The Bonin score evaluated the patient's level of knowledge aboutthe disease as acceptable within 38% of the studied population and the level of activation was level 4 within 35% of the sample. There was a weak positive correlationbetween the analyzed forms. Conclusion: This study showed a low level of activationand knowledge of the disease for the patients treated at a specialized heart failure clinic. There is a positive correlation between patient activation and knowledge of thedisease. This may enable targeted planning and educational measures focused on expanding their knowledge and engagement in their health care. Keywords: Patient-Centered Care; Self-management; Self-care; Heart Failure; Health Information Exchange.
Description
Palavras-chave
Assistência Centrada no Paciente, Autogestão, Autocuidado, Insuficiência Cardíaca, Troca de Informação em Saúde, Patient-Centered Care, Self-management, Self-care, Heart Failure, Health
Information Exchange
Citação
Carvalho GM. Conhecimento da doença e nível de ativação do paciente ambulatorial com insuficiência cardíaca crônica: um estudo tranversal. Dissertação [Mestrado Profissional em Ciências Cardiovasculares]. Instituto Nacional de Cardiologia; 2023.